I treat them the same:
I stop CPR on transfer to the ED gurney. If no signs of life in the field, I
ultrasound the heart. No motion equals dead, and the resuscitation stops.
Motion on ultrasound or signs of life in the field gets a resuscitative
thoracotomy, and any epinephrine goes into the heart. At my institution, I
have ZERO control over meds given in the prehospital setting.
FOR ISOLATED OR CONCOMITANT MASSIVE HEAD INJURIES: I treat them per ACLS
protocol.
Scott Bricker, M.D.
Torrance, CA
Sent via DROID on Verizon Wireless
-----Original message-----
From: caesar ursic <cmursic at gmail.com>
To: "Trauma-List [TRAUMA.ORG]" <trauma-list at trauma.org>
Sent: Wed, Dec 1, 2010 22:00:38 GMT+00:00
Subject: Vasopressors in prehospital traumatic arrest
What, if any, is the role of epinephrine or atropine (the "typical" ACLS
cardiac arrest drugs) in prehospital traumatic arrest?
Do you approach the 35 year old who has had 15 mins of prehospital CPR after
falling off a third story balcony (because he was found "pulseless and
bradycardic" at the scene) once he arrives in your ER any differently if he
has / has not received multiple doses of epi and atropine (assuming that the
patient is still pulseless but has some sort of ECG rhythm on arrival)?
Just curious.
CM Ursic, MD
Honolulu
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